两例机器人辅助腹腔镜子宫切除术后性交后阴道残端裂开伴小肠脱出病例
Two cases of post-coital vaginal cuff dehiscence with small bowel evisceration after robotic-assisted laparoscopic hysterectomy.
作者信息
Nguyen My-Linh T, Kapoor Monica, Pradhan Tana S, Pua Tarah L, Tedjarati Sean S
机构信息
Department of Obstetrics and Gynecology, Westchester Medical Center of New York Medical College, United States.
出版信息
Int J Surg Case Rep. 2013;4(7):603-5. doi: 10.1016/j.ijscr.2013.04.001. Epub 2013 Apr 10.
INTRODUCTION
Vaginal cuff dehiscence following robotic surgery is uncommon. Published reports of vaginal cuff dehiscence following robotic surgery are increasing, but the true incidence is unknown.
PRESENTATION OF CASE
Case 1. A 45 year old female had sexual intercourse and presented with a vaginal cuff dehiscence complicated by small bowel evisceration 4 months after RA-TLH. Case 2. A 44 year old female had sexual intercourse and presented with a vaginal cuff dehiscence with small bowel evisceration 6 weeks after RA-TLH.
DISCUSSION
We discuss the rate of vaginal cuff dehiscence by mode of hysterectomy, surgical and non-surgical risk factors that may contribute to vaginal cuff dehiscence, and proposed preventative methods at the time of RA-TLH to reduce this complication.
CONCLUSION
Vaginal cuff dehiscence with associated evisceration of intraabdominal contents is a potentially severe complication of hysterectomy. We recommend counseling patients who undergo RA-TLH to abstain from vaginal intercourse for a minimum of 8-12 weeks.
引言
机器人手术后宫旁组织裂开并不常见。关于机器人手术后阴道断端裂开的已发表报告在增加，但真实发生率尚不清楚。
病例介绍
病例1. 一名45岁女性在机器人辅助全子宫切除术后4个月发生性行为，并出现阴道断端裂开，并发小肠脱出。病例2. 一名44岁女性在机器人辅助全子宫切除术后6周发生性行为，并出现阴道断端裂开，伴有小肠脱出。
讨论
我们讨论了子宫切除术方式导致阴道断端裂开的发生率、可能导致阴道断端裂开的手术和非手术风险因素，以及在机器人辅助全子宫切除术时提出的预防方法，以减少这种并发症。
结论
阴道断端裂开并伴有腹腔内容物脱出是子宫切除术的一种潜在严重并发症。我们建议对接受机器人辅助全子宫切除术的患者进行咨询，建议其至少8至12周内避免阴道性交。
Zotero 插件